Immunological and Biochemical Profiles in Rheumatoid Arthritis: Sex-Dependent Variations and Organ Function Implications

Background: Rheumatoid arthritis (RA) is a systemic autoimmune disease characterised by chronic inflammation, primarily affecting the joints, but it can also impact multiple organ systems. The disease disproportionately affects females and is associated with immunological, haematological, hepatic, and renal alterations. Monitoring these parameters can provide insights into disease severity, treatment compliance, and sex-specific responses. Methodology: This case-control study included 50 RA patients (30 females 60%, 20 males 40%) and 30 healthy controls. The disease duration ranged from 1 to 28 years, with the majority (28%) having a duration between 1 and 4 years. Eighty per cent of patients were compliant with treatment. Blood and biochemical tests were performed to evaluate inflammatory markers (ESR, CRP, IL6, TNF, Anti CCP)by Eliza technique, liver enzymes (ALT, AST, ALP, TSB, albumin), renal function tests (urea, creatinine) by Specterophotometer, and trace elements (copper by Atomic Absorption Spectrophotometry (AAS), ceruloplasmin by Immunoturbidimetric assay, transferrin by Immunoturbidimetry through Roche Cobas c501/c601 device). Results: RA patients showed significantly elevated inflammatory markers compared to controls, including Anti-CCP (Females: 32.33 10.85 IU/mL; Males: 31.90 8.55 IU/mL), IL6 (Females: 61.90 to12.62 ng/L; Males: 66.55 to 10.32 ng/L), and TNF (Females: 198.80 50.95 ng/L; Males: 234.95 83.43 ng/L) (P<0.01). ESR was significantly higher in RA patients (Females: 55.53 33.96 mm/h; Males: 38.00 18.12 mm/h) versus controls. Liver function was impaired in RA patients, with increased ALT, AST, and TSB levels, and decreased albumin and ALP. Kidney function markers (urea and creatinine) were elevated in females but comparatively reduced in males. Trace elements showed high copper and ceruloplasmin levels in RA patients of both sexes compared to controls, while transferrin was notably higher in males with RA (53.90 11.48 ng/mL vs. 28.08 4.33 ng/mL in controls). Conclusion: RA significantly affects immunological, hepatic, renal, and haematological profiles, with marked differences between sexes. Female patients exhibited more profound renal and lymphocytic alterations, whereas male patients showed elevated transferrin levels. These findings highlight the importance of comprehensive, sex-specific monitoring of RA patients, particularly focusing on inflammatory and organ function biomarkers, to improve disease management and patient outcomes.